%0 Journal Article
%T Antithrombotic Therapy in Patients With Infective Endocarditis: A Systematic Review and Meta-Analysis.
%A Caldonazo T
%A Musleh R
%A Moschovas A
%A Kirov H
%A Franz M
%A Haeusler KG
%A Faerber G
%A Doenst T
%A Günther A
%A Diab M
%J JACC Adv
%V 3
%N 2
%D 2024 Feb
%M 38939390
暂无%R 10.1016/j.jacadv.2023.100768
%X <B>UNASSIGNED: </B>Antithrombotic therapy (ATT) in patients with infective endocarditis (IE) is challenging.<BR><B>UNASSIGNED: </B>The authors evaluated the impact of anticoagulant and antiplatelet therapy on clinical endpoints in IE patients.<BR><B>UNASSIGNED: </B>We performed a systematic review and meta-analysis comparing IE patients with prior and/or ongoing use of ATT vs those without any ATT during IE course. Primary outcome was reported in-hospital cerebrovascular events. Secondary outcomes were in-hospital mortality, intracranial hemorrhage (ICH), systemic thromboembolism (ST), and mortality within 6 months.<BR><B>UNASSIGNED: </B>Twelve studies, with a total of 12,151 patients, were included. The primary endpoint was not different comparing 10,115 IE patients with or without prior anticoagulation (OR: 1.10; 95% CI: 0.56-2.17; P = 0.77) or comparing 838 IE patients with or without prior antiplatelet (OR: 0.90; 95% CI: 0.61-1.33; P = 0.61). In-hospital mortality was lower in IE patients with prior anticoagulation compared to those without (OR: 0.74; 95% CI: 0.57-0.96; P = 0.03). There was no difference in reported ICH rates between patients with or without prior anticoagulation (OR: 0.54; 95% CI: 0.27-1.09; P = 0.09) or between patients with or without prior antiplatelet (OR: 0.35; 95% CI: 0.11-1.10; P = 0.07). The rate of ST was lower in IE patients with prior antiplatelet therapy compared to those without (OR: 0.53; 95% CI: 0.38-0.72; P < 0.01).<BR><B>UNASSIGNED: </B>ATT in IE patients was not associated with higher frequency of cerebrovascular events or ICH. Moreover, we found that the use of anticoagulation was associated with decreased in-hospital mortality and the use of antiplatelets was associated with decreased ST. Due to the limitations of this study, these results should be interpreted cautiously showing the necessity of a randomized setup.